Open Recommendations

We recommend that the Texas Department of Health and Human Services improve oversight and monitoring of providers.

We recommend that the Texas Department of Health and Human Services work with providers to improve their facilities, staffing, and training.

We recommend: USAID/Ukraine's Controller:
Require Ednannia to perform a thorough review of both the General Ledger and the incurred cost submission to identify the root cause of the $27.16 variance. This should include verifying data entry processes, confirming the timing of entries and ensuring that all adjustments are accurately reflected in both records, adjust in ledger system accordingly to minimize future variances

We recommend: USAID/Ukraine's Controller:
Require Ednannia to implement a more rigorous reconciliation process between the General Ledger and incurred cost submissions, ensuring that all discrepancies are promptly identified, investigated, and resolved. This process should be documented and reviewed periodically.

We recommend: USAID/Ukraine's Controller:
Require Ednannia to consider the use of automated financial systems or software to streamline the reconciliation process, reduce the risk of human error, and improve the accuracy of financial data entries.

Clarify policies, guidance, and/or training on when admissions holds, removal of veterans from grantee facilities, and the withholding or suspension of per diem payments are appropriate and required.

Clarify policies, guidance, and/or training on how facility staff determine whether corrective actions for an identified problem related to a grantee should be required or suggested, including what factors to consider, who makes the final determination, and whether and how the determination is reviewed by others.

Implement a mechanism designed to reasonably ensure that VA oversight staff take appropriate enforcement measures to address persistent or recurring deficiencies by a Grant and Per Diem grantee that pose risks to veteran care and safety.

Create the Governance Charter and hold regular meetings with the Risk Management Committee.

Update and finalize an ERM roadmap from 2020 which includes estimated and actual completion dates.

Develop Annual Risk Analysis Reports and distribute to the various divisions.

Implement an Enterprise Governance, Risk and Compliance (eGRC) Tool which will help aggregate risks across the enterprise and map them to strategic objectives.

Enhance ERM communication channels and hold regular meetings between the ERM team and departments.

Increase CFTC leadership support and conduct regular briefings and workshops, and actively participate in ERM activities.

Foster a collaborative environment by appointing ERM liaisons within each division.

Conduct training sessions to educate employees about the ERM program and its benefits.

Create standardized procedures to conduct ERM assessments including guidelines for risk identification, assessment, mitigation, and monitoring.

Define its ERM risk rating methodology to consistently evaluate and prioritize risks and align this methodology with the organization’s risk appetite and tolerance levels.

Maintain a centralized risk register to document all identified risks as well as the risk owners, mitigation strategies, and monitoring plans.

Establish a timeline and criteria for conducting regular risk assessments and continuously monitoring and managing risk with at least an annual risk assessment.

Regularly review and update the ERM program to incorporate best practices and lessons learned to strive for continuous improvement.

Enhance its ERM team capacity and prioritize hiring skilled ERM professionals and provide ongoing training to existing staff.

Ensure ERM considerations are integrated into the strategic planning process with active involvement from senior executives.

We suggest CFTC to also Improve its processes by investing in technology that supports ERM activities, such as risk assessment tools and data analytics platforms.

Address budget constraints by reevaluating the resources dedicated to the ERM program and exploring cost-effective solutions and tools to enhance the ERM program without significant financial investment.